- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.34 / $186.34 / $186.34
| Facility | | $186.34 | $186.34 | $186.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.20 / $416.41 / $774.34
| Facility | | $341.20 | $416.41 | $774.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.71 / $585.27 / $1,407.95
| Facility | | $412.71 | $585.27 | $1,407.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.50 / $535.08 / $1,108.63
| Facility | | $335.50 | $535.08 | $1,108.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $196.40 / $341.51 / $3,500.00
| Facility | | $196.40 | $341.51 | $3,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.00 / $3,500.00 / $8,152.00
| Facility | | $1,751.00 | $3,500.00 | $8,152.00 |